Drug therapy and hazardous substances committee

Question 1

what are some factors associated with fatalities from over the counter cough medications (6)

Answer 1

age <2 
daycare use
combining 2 medications
failure to use a measuring device
product misidentification
use of products intended for adults

Question 2

does Health Canada recommend over the counter cough medications?

Answer 2

not recommended in age <6
OTC CCMs may be associated with medication errors and adverse events, resulting in visits to emergency departments and even leading to death.

Question 3

the inappropriate use of azithromycin has led to resistance of what?

Answer 3

macrolide resistant pneumococci

Question 4

should azithromycin be used to treat acute OM? what is one exception?

Answer 4

No! Has lead to strep Pneumonia resistance and not as effective for H. influenza.
only use if anaphylaxis with penicillin

Question 5

what are the two clinical situations for which you would consider treating a child with azithromycin

Answer 5

1. anaphylactic allergy to penicillin, can be used as second line to treat acute pharyngitis (GAS macrolide sensitive)
2. pneumonia caused by atypical bacteria

Question 6

what are 3 steps to enhance folate intake in women of child-bearing age (4)

Answer 6

encouraging the consumption of folate-rich foods such as leafy vegetables
increasing the level of folate food fortification
taking a supplement containing folate and B12
providing free folate supplementation to disadvantaged women of child-bearing age.

Question 7

when do neural tube defects occur

Answer 7

during 3-4th week of gestation

Question 8

What is the risk of NTD recurrence in a women who has previously given birth to an affected child

Answer 8

There is a 2% to 5% risk of recurrence in women who have previously given birth to an affected child

Question 9

How much folic acid should women of child-bearing years take?

Answer 9

daily supplement of 0.4 to 1 mg of folic acid to reduce the risk of NTDs.
for at least 2-3 months before conception and throughout the pregnancy and postpartum periods (for a minimum of four to six weeks and as long as breastfeeding continues)

if previous NTD then 5mg folic acid daily until 10-12 weeks post conception

Question 10

‘first principles’ with regard to CAM in children (4)

Answer 10

First, do no harm
Ensure no opportunity cost (ie, do not delay treating a serious illness for which there is known effective therapy);
If the CAM therapy carries little risk of harm, then consider its use and follow the patient closely;
If the CAM therapy carries serious risk of harm, advise the patient accordingly and follow the patient closely;
Where possible, it is recommended to try to follow an evidence-based rationale for therapy; and
Where the evidence is lacking, try to maintain an open mind and a balanced approach.

Question 11

The psychoactive properties of cannabis are primarily produced by what compound?

Answer 11

delta 9 THC

Question 12

The most predictable side effects associated with marijuana use what? (4)

Answer 12

red eyes
dry mouth
delayed motor skills
tachycardia